{
  "abstract": "Background Productivity and health are frequently discussed assuming a positive linear relationship, yet empirical interrogations are often superficial. Given the complex and varying place-based determinants of health, we posited that area-based divergence in the relationship between these variables is likely. We examined national data from England relating to health and economic performance from 2018 and 2023 to determine if the assumption of a positive linear relationship between economic productivity and health exists for all local authorities (LAs).Methods We analysed indicators across health and economic productivity. The seven physical and mental health indicators were: healthy life expectancy at birth (males and females), crude mortality, mortality from cardiovascular disease, mortality from cancer, premature mortality in adults with severe mental illness (SMI); and excess under-75 mortality in adults with SMI. The data, collected from 2018 to 2023, were retrieved from the Department of Health and Social Care Fingertips webpage in November 2024. Data for economic productivity (gross value added per hour worked and gross household disposable income) was published in June 2024 and retrieved from the Office of National Statistics webpage. We selected LAs districts from England referencing the 2019 Indices of Multiple Deprivation. We conducted multiple cluster analysis to identify the health and economic productivity profiles of the local authorities. The results were compared to identify patterns between productivity and health outcomes.Results Local authorities clustered into three groups based on productivity and health outcomes. Although some clusters reinforced the assumption of a positive linear relationship between health and productivity, there were notable variations. Twenty-two out of 198 low-productive local authorities showed no poor health outcomes and good outcomes in four or more of the seven health indicators.Conclusion This study challenges dominant deterministic framings of the relationship between health and productivity, representing an opportunity to better understand drivers of local differences and their respective developments.",
  "authors": [
    {
      "affiliations": [
        "NIHR PRU BaSS, Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Eunice Twumwaa Adwubi"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Jack M Birch"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Chris Bonell"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Amy O’Donnell"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Luke Vale"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, UK",
        "NIHR PRU BaSS, Centre for Health, Wellbeing and Behaviour Change, Clinical, Educational and Health Psychology, University College London, London, UK"
      ],
      "name": "Angel Chater"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK",
        "Department of Public Health and Primary Care, Cambridge Public Health, University of Cambridge, Cambridge, UK"
      ],
      "name": "Michael Kelly"
    },
    {
      "affiliations": [
        "NIHR PRU BaSS, Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Emily J Oliver"
    }
  ],
  "title": "P11-5 Exploring variability in the relationship between economic productivity and physical and mental health in England: a cluster analysis of local authority level data",
  "uid": "003abe86-3a83-5f84-8bfd-9d7a60beb451"
}